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Individual

DR. JOHN GOULD III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
7430 COLLEGE ST, IRMO, SC 29063-2903
(839) 200-7810
(803) 891-7085
Mailing address
7430 COLLEGE ST, IRMO, SC 29063-2903
(839) 200-7810
(803) 891-7085

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
00632
SC
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
632
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006326
SC
Enumeration date
09/16/2005
Last updated
01/07/2022
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